I have the same HMO dilemma. I have private HMO insurance, and they won't pay for anyone who is not a "preferred provider." They won't even pay for lab tests, us's , etc, if it is not ordered by a dr. on their list. A midwife I spoke to said that HMO's can get away with this simply because they are not saying they won't pay for midwives- they just won't pay for anyone that they do not contract with and put on their provider list. The doctors on the provider list agree to bill services at a lower than normal rate for HMO members- in return, the HMO will give the Dr.s a certain amount of money each month for those members, regardless of whether or not they visit the Dr. ( i know this since I work at a HMO medical clinic.) If you have a PPO provider that allows you to see any Dr, then you can force them to pay for a portion of a homebirth. this is all in CA, so I imagine NY could be different. I have no idea if Medicaid would make a difference. HMOs suck!!
I hate to have the cost keep me from considering a homebirth. Midwives out here generally aren't cheap, plus any lab tests are additional to their fees. I was thinking of seeing an HMO ob for the initial labs, then transferring to a midwife. I'm not sure. Good luck to you, and if you find any info, let me know!!!
I'd love to find a loophole, but doubt if I will.
Take care, Becky